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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2022; 32(04): 451-459
DOI: 10.1055/s-0042-1753469
Original Article

Multidetector Computed Tomography Perfusion in Head and Neck Squamous Cell Carcinomas: Evaluation of a Dose Reduction Strategy

Shuchi Bhatt
1   Department of Radio-diagnosis, University College of Medical Sciences, University of Delhi, Delhi, India
,
Samrat Mandal
1   Department of Radio-diagnosis, University College of Medical Sciences, University of Delhi, Delhi, India
,
Gopesh Mehrotra
1   Department of Radio-diagnosis, University College of Medical Sciences, University of Delhi, Delhi, India
,
Vipin Arora
2   Department of Otorhinolaryngology, University College of Medical Sciences, University of Delhi, Delhi, India
,
Usharani Singh
3   Department of Pathology, University College of Medical Sciences, University of Delhi, Delhi, India
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Abstract

Background Computed tomography perfusion (CTp), a useful technique in oncology, is not widely utilized due to the high radiation dose delivered from it. It involves scanning the region of interest every second for 50 seconds following intravenous contrast administration. Doubling sampling interval (SI) to 2 seconds will half the radiation dose, but may impact its effectiveness, which needs to be evaluated.

Objectives To evaluate a dose reduction strategy in CTp by determining agreement between standard dose (SD) CTp (acquisition with SI 1 second) and low-dose CTp techniques with SI of 2 seconds (achieved either by reconstruction only or true low-dose acquisition).

Materials and methods This cross-sectional study was conducted on histopathology-proven head and neck squamous cell carcinoma (HNSCC) patients who underwent CTp on 64 slice multidetector CT. A total of 56 patients had SD and 24 patients underwent true low dose (LD) acquisition. SD data were also reconstructed at SI 2 seconds to obtain a dataset simulating low dose (low-dose reconstruction [LDr]). Paired t-test was applied to compare CTp in SD and LDr groups and the Bland–Altman plot drawn to calculate 95% confidence limit of agreement. The Kolmogorov–Smirnov test compared CTp parameters for LDr and LD groups.

Results There was no statistical difference in CTp parameters (except blood flow in malignant) in SD and LDr groups for both malignant and normal tissues. CTp of malignant tissue was not statistically different in LDr and LD groups but the radiation dose was half in the LD group.

Conclusion Reduction of radiation dose to half achieved by doubling the SI does not affect the CTp parameters significantly. So LD acquisitions will increase the use of CTp in HNSCC.

Keywords

CT perfusion - sampling interval - dose reduction - head and neck - squamous cell carcinoma

Copyrighted Material

None used. This work has not been published previously or sent for any publication elsewhere. Publication is approved by all authors and explicitly by the responsible authorities. If accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright holder. Tables 1 to 6 are based on authors' own work.




Publication History

Article published online:
31 July 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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